TBE in Finland

Finland is at the northernmost edge of the TBE endemic area in Europe. Here TBE is focally endemic. An aseptic encephalitis disease has been known in Kumlinge Island in Åland Islands since the 1940s.1 TBE is also known in Finland by name Kumlinge disease.

TBE in Finland

Finland is at the northernmost edge of the TBE endemic area in Europe. Here TBE is focally endemic. An aseptic encephalitis disease has been known in Kumlinge Island in Åland Islands since the 1940s.1 TBE is also known in Finland by name Kumlinge disease.

Long-term Outcomes of Acute Aseptic Encephalitis In Adults - a Single Center Study

Background Encephalitis is a heterogeneous syndrome associated with significant mortality and neurophysiological sequelae. The etiology is identified in only 20–50% of cases, and long-term outcomes of survivors are underinvestigated, especially in patients with unknown etiology. The aim of this study was to describe long-term outcomes of patients with aseptic encephalitis of various etiologies. Methods The study population consisted of a retrospectively identified cohort of consecutive adult patients diagnosed with viral and etiologically undiagnosed encephalitis during a 24-month period (2014-2015) at the University Hospital for Infectious Diseases Zagreb, Croatia. Clinical, laboratory data and short-term outcomes were collected from medical records, and long-term outcomes were assessed by telephone interviews and quantified through modified Rankin scores (mRS). Results A total of 90 patients were identified (57.7% female; 51.5 ± 17.4 years). Viral etiology was identified in 20 (22.2%) patients: herpes simplex virus (HSV-1, 8.9%), varicella-zoster virus (VZV, 6.7%), Tick-borne encephalitis (TBE, 4.4%) and enteroviruses (2.2%). Postinfectious meningoencephalitis was suspected in 14 (15.6%) patients, and 56 (62.2%) had unknown etiology. Elevated CSF WBC was present in 77 patients (mean of 169.3 ± 279.4/mm3) and all but 6 had elevated CSF proteins (1.23 ± 0.88 g/L). Convulsions occurred more frequently in HSV-1 (37.5%) and in unknown etiology group (15.7%). GOS<3 was noted in 50% of HSV, 33% of VZV, 25% of TBE and 24% of unknown group patients during hospitalization. Mechanical ventilation was necessary in 17.1% of patients with unknown and 23.5% with viral etiology for the mean duration of 1.8 ± 6.7 and 3.2 ± 6.3 days, respectively. The mean length of stay was 23.2 ± 18.5 days. In-hospital mortality was 7.8%. Among 64 survivors who were available for follow-up interviews (mean follow-up of 28.6 ± 6.8 months), 73.1% with unknown and 90.9% with viral etiology had favorable outcomes (mRS 0–1); 4 (6.25%) had moderate (mRS 3) and 3 (4.6%) had severe neuropsychological deficits (mRS 4-5). Conclusion Although the etiology of aseptic encephalitis is often unknown, long-term outcomes are favorable in the majority of patients. Disclosures All authors: No reported disclosures.